Baptism by fire

Saturday Hernan and I set off for the airport in Hernan's beautiful red coaster with an operating microscope and stand, a slit lamp (don't ask me what it does!), an autoclave (sterilizer), and boxes full of sterilized water, scrub soap, and snacks. We were on our way to pick up our crew of 8 for the coming week of cataract surgeries, and I got so preoccupied with all the preparations that I forgot to check the plane status. Folly! When we got to the airport, we soon found that the plane (normally due at 7:45 PM) had been delayed and was now scheduled for 11 PM. We settled down to wait, which is such an ongoing part of life in El Salvador, and I checked in with the airport authority police from time to time about whether and when they would let me go in to meet our passengers (and their baggage). I waved my set of franquisia papers around a lot - these allow us to import the medications we were bringing in without paying any customs duty, and I was of the opinion that it was going to make it easy to get our equipment and medications through customs. I was wrong.

The plane finally did arrive - at about 1 AM - and our group assembled at the customs line. I waved my franquisia again, and the customs agent started going through it with a fine tooth comb. He looked through the list, written in English (and already approved by the body that approves medicine imports), and wanted to know the translation for every term. Charo Sanchez from Bellingham, our interpreter for this mission, gamely went through the list as he made notes. Then he started looking up the medications on his computer. Then he told us that because we were bringing in anesthetics (the local anesthetics used to numb the eye for surgery), our import would have to be approved by the anti-narcotic division, but they were not at the airport at this hour (by now it was 2:30 AM), and furthermore the import would have to be approved by the anti-narcotics division chemist, and he only worked Monday through Friday, but maybe he would come in tomorrow to take a look at our anesthetics.

OK, we said, gritting our teeth (much toothgrinding going on), OK, keep the medications and we'll come back for them tomorrow, but let us take the rest of the things we need to have tomorrow to set up the operating room - the scrubs and patient gowns and sutures and eye patches and sterile gloves, and so on. No, he said, it's all on the one franquisia, so nothing in the whole shipment can be taken until it all has been approved.

We were a shell-shocked and completely exhausted bunch by now and it was clear that nothing was going to budge our customs agent, so we climbed wearily into Hernan's bus and went to the Hotel Novo, where a very sleepy looking night clerk let the group in at 3:30. I went back home and slept (blissfully) for four short hours.

We had managed to come away with a phone number and name to call the next day. When Charo called she talked to someone who said oh yes, no problem, everything's approved, come on down and get it. So Charo and Dra. Silvia Pleitez and I climbed on to Hernan's bus and rode down to the airport. The woman Charo had talked to said we didn't need to go to the Port Authority police to get permission to enter the Customs area - but we did. Another lengthy set of explanations, and we were back in customs, and the same customs agent was there, glumly filling out yet more forms. Can we pick the boxes up now? we said. It's going to be another 20 minutes, they said. Finally, after a half hour that felt like eternity, they had Charo sign her name on about 15 different pieces of paper, and they turned loose our equipment, and we loaded it into the bus and headed back to San Salvador.

Finally, today, we did get to the hospital, we did set up the surgery suite, we are ready for patients tomorrow - but I hope never to go through anything quite like the last 48 hours again. You can probably see the accumulated strain in the tired face of Charo, sitting on the right next to Silvia in the photo above. Behind them are the liberated boxes and duffel bags and tubes, taking up more than half of the coaster. Behind us, for this time anyway, is the customs office.